Some of us remember the struggle for political liberation. Indeed, only yesterday we were fighting for our liberation from colonialism … Only yesterday did we leave the delivery room, smiling, with a newborn baby: a free and independent Africa … And just as we began to smile, watching this child lift its foot to take its first step as an independent being … bang! Another oppressor struck Africa: HIV/AIDS!

… Our worst enemy is among us. It is everywherebetween men and women, boys and girls, husbands and wives. It is in the beds of our intimacyin the best moments of our lives. When we kiss and make love, the enemy is there. It is now in our veins, in our blood, in our cells, in our fluids, in our minds. HIV/AIDS makes love drag us to death.

Musa Dube, HIV/AIDS and the Curriculum: Methods of Integrating HIV/AIDS in Theological Programmes.

Penn doctors, nurses, and scholars are collaborating with their counterparts in Botswana to try to change the course of HIV/AIDS (and health-care itself) in one of the countries hit hardest by the disease.

Around daybreakthe patients start showing up at Botswana’s largest HIV clinic. Most are women, who “seem to bear the brunt of the disease,” according to Dr. Mpho Sebonego, a Penn-supported doctor working at Princess Marina Hospital (PMH) in Gaborone. It’s first-come-first-served, so they sign in and sit on benches, talking with one another to pass the hours until they’re seen. The waiting room is air-conditioned, but that’s hard to tell with the outside doors always kept open.

“That’s my people for you,” Sebonego observes in an email. “The heat would be unbearable outside, but they would have the air-con blasting with doors open.”

Despite his occasional sarcasm, Sebonego has wanted to be a doctor for his people since he was a “wee lad” growing up in a rural village 50 miles southwest of the capital city. He studied medicine in the Caribbean, England, and the United States, but he’s back in his home country at a time when more doctors are sorely needed.

With an estimated one-third of its citizens ages 15-49 infected with HIV, Botswana is both a trouble zone and a bright spot in Africa. Its diamond mines have fueled its economic growth, and it has a government determined to do something about the epidemic. For the past six years, Penn has been a leader in this effort and is expanding its presence in ways that may shape health-care throughout the country.

COVER STORY :Prognosis Botswana By Susan FrithPhotography by Rick Cushman

(Left) Dr. Stephen Gluckman, clinical director of the Penn-Botswana program, thought that the country would be a good place for Penn medical students and residents like Marah Gotcsik M’07 to get some overseas experience. The inpatient wards at Princess Marina Hospital in Gaborone, Botswana, are a far cry from HUP.